Research School of Population Health, Australian National University, Canberra, Australian Capital Territory, Australia.
Sydney Pharmacy School and Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia.
Intern Med J. 2019 Jan;49(1):84-93. doi: 10.1111/imj.14134.
Adverse drug reactions (ADR) are severe problems in global public health, and result in high mortality and morbidity. Various trends of ADR-related hospitalisations have been studied in many countries, while estimates of the trends in Australia are limited.
To examine trends in ADR-related hospitalisations in New South Wales (NSW).
Data were extracted from the Admitted Patient Data Collection, a census of hospital separations in NSW. We estimated age-adjusted rates of ADR-related hospitalisation between 1 July 2001 and 30 June 2014 and rates by patient characteristics, main therapeutic medication groups and clinical condition groups that warranted the hospitalisation. We used the percentage change annualised estimator to evaluate rates over time.
A total of 315 274 NSW residents admitted for urgent care of ADR was identified. The age-adjusted rates of ADR-related hospitalisations nearly doubled and increased by 5.8% (95% CI: 5.0-6.6%) per annum, with an in-hospital death rate increase of 2.4% (1.6-3.3%). Agranulocytosis (2.7%), nausea and vomiting (2.4%) and heart failure (2.4%) were the most common conditions that led to ADR-related hospitalisations over 13 years, with acute renal failure (1.4%) recently emerging as the leading adverse condition. Participants aged between 65 and 84 years accounted for nearly half of ADR hospitalisations (45.6%), with age-adjusted rate increasing from 103.9 in 2001-2002 to 189.0 per 100 000 NSW residents in 2013-2014. Anticoagulants (13.5%) were the most common medications contributing to ADR-related hospitalisation, followed by opioid analgesics (9.6%).
ADR-related hospitalisation remains a population health burden, with significant increase over time. The findings call for continuing efforts to prevent ADR, especially among high-risk populations, such as older people.
药物不良反应（ADR）是全球公共卫生的严重问题，导致高死亡率和发病率。许多国家已经研究了与 ADR 相关的住院治疗的各种趋势，而澳大利亚的估计数据有限。
检查新南威尔士州（NSW）与 ADR 相关的住院治疗趋势。
从住院患者数据采集（Admitted Patient Data Collection）中提取数据，该数据是 NSW 住院患者的普查。我们估计了 2001 年 7 月 1 日至 2014 年 6 月 30 日期间与 ADR 相关的住院治疗的年龄调整率，并按患者特征、主要治疗药物组和临床情况组进行了分类，这些情况组需要住院治疗。我们使用年度百分比变化估计值来评估随时间的变化率。
确定了 315274 名 NSW 居民因急性 ADR 护理而入院。与 ADR 相关的住院治疗的年龄调整率几乎翻了一番，每年增加 5.8%（95%CI：5.0-6.6%），住院死亡率增加了 2.4%（1.6-3.3%）。粒细胞缺乏症（2.7%）、恶心和呕吐（2.4%）和心力衰竭（2.4%）是导致 13 年来与 ADR 相关的住院治疗的最常见疾病，急性肾衰竭（1.4%）最近成为主要不良疾病。年龄在 65 至 84 岁之间的患者占 ADR 住院治疗的近一半（45.6%），年龄调整后的比率从 2001-2002 年的 103.9 上升到 2013-2014 年的 189.0 每 100000 名 NSW 居民。抗凝剂（13.5%）是导致与 ADR 相关的住院治疗的最常见药物，其次是阿片类镇痛药（9.6%）。
与 ADR 相关的住院治疗仍然是人口健康的负担，随着时间的推移呈显著增加。这些发现呼吁继续努力预防 ADR，特别是在老年人等高危人群中。
